Oligodendroglioma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Sujit Routray, M.D. [3]

Overview

When evaluating a patient for oligodendroglioma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough past medical history review. Other specific areas of focus when obtaining the history include review of common risk factors such as family history of brain tumors. Symptoms associated with oligodendroglioma include seizure, headache, nausea, vomiting, vertigo, visual loss, diplopia, strabismus, muscle weakness, numbness, speech difficulties, mood disturbances, and personality changes.

History

  • While evaluating a patient for oligodendroglioma, a detailed history of the following should be taken:[1]
    • Presenting symptom:
      • Onset
      • Duration
      • Progression
    • Other associated symptoms
    • A thorough past medical history review
    • Review of common risk factors such as:

Symptoms

  • Oligodendroglioma is a slow-growing, infiltrative tumor that may be clinically silent for many years
  • Asymptomatic patients are diagnosed based on incidental findings at the time of brain imaging performed for another reason (eg, trauma, migraine headaches)
  • Focal neurologic deficits and generalized symptoms such as headache are uncommon at the time of diagnosis
  • With tumor progression, symptoms may vary depending on following characteristics of tumor:
    • Location
    • Size
    • Rate of tumor growth
  • It mainly involves the frontal lobe
  • Common symptoms associated with oligodendroglioma include:[2][3][4][5][6]
    • Seizure (usually the first and most common presentation in 50-80% of the cases)[7]
    • Headache
    • Nausea
    • Vomiting
    • Vertigo
    • Focal neurological deficits depending upon tumor location (symptoms usually caused by local tissue disruption, mass effect on nearby structures, or vasogenic edema) include:
    • Cognitive dysfunction includes:
      • Memory problems
      • Changes in mood
      • Changes in personality
      • Low energy
      • Fatigue
      • Urge to sleep
      • Loss of interest in daily activities
      • Abulia (showing abnormal inability to act or make decisions)
      • Lack of spontaneity
    • Increased intracranial pressure (either due to a large mass or any restriction in cerebrospinal fluid outflow causing hydrocephalus) associated with following symptoms:
      • Classic triad that includes:
        • Headache
        • Nausea
        • Papilledema
      • Loss of consciousness with syncope (maybe associated with a few tonic-clonic jerks)
Oligodendrogliomas symptoms according to tumor site
Tumor site of involvement Clinical features
Frontal lobe
  • Weakness on one side of body
  • Personality or behavior changes
  • Difficulty with short-term memory
Temporal lobe
  • Usually “silent”
  • Few symptoms
  • Seizures or language problems

References

  1. McCarthy BJ, Rankin KM, Aldape K, Bondy ML, Brännström T, Broholm H; et al. (2011). "Risk factors for oligodendroglial tumors: a pooled international study". Neuro Oncol. 13 (2): 242–50. doi:10.1093/neuonc/noq173. PMC 3064625. PMID 21149253.
  2. Douay X, Daems-Monpeurt C, Labalette P, Blond S, Petit H (1997). "[Bilateral 3rd cranial nerve palsy disclosing oligodendroglioma]". Rev Neurol (Paris). 153 (6–7): 430–2. PMID 9684012.
  3. Hata N, Shono T, Mizoguchi M, Matsumoto K, Guan Y, Nagata S; et al. (2007). "Loss of heterozygosity analysis in an anaplastic oligodendroglioma arising after radiation therapy". Neurol Res. 29 (7): 723–6. doi:10.1179/016164107X208068. PMID 17553214.
  4. Ogasawara H, Kiya K, Uozumi T, Sugiyama K, Kawamoto K, Ohta M (1990). "Multiple oligodendroglioma--case report". Neurol Med Chir (Tokyo). 30 (2): 127–31. PMID 1695334.
  5. Raciti-Daurio C, Caruso J (1990). "Oligodendroglioma--a case presentation". Optom Vis Sci. 67 (1): 56–8. PMID 2308753.
  6. Rodriguez FJ, Tihan T, Lin D, McDonald W, Nigro J, Feuerstein B; et al. (2014). "Clinicopathologic features of pediatric oligodendrogliomas: a series of 50 patients". Am J Surg Pathol. 38 (8): 1058–70. doi:10.1097/PAS.0000000000000221. PMC 4322928. PMID 24805856.
  7. Cavaliere R, Farace E, Schiff D (2006). "Clinical implications of status epilepticus in patients with neoplasms". Arch Neurol. 63 (12): 1746–9. doi:10.1001/archneur.63.12.1746. PMID 17172614.


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